The Influence of Gastroesophageal Reflux on Oral Soft Tissue Lesions: A Narrative Review

Aim: This narrative review aimed to evaluate the influence of gastroesophageal reflux disease (GERD) on oral soft tissue lesions, with a focus on erythema, ulcerations, burning mouth syndrome (BMS), mucosal atrophy, and epithelial dysplasia. Materials and Methods: A narrative review of observational and limited interventional studies was conducted. Data were drawn from published studies in Western and Asian populations, examining oral mucosal changes in patients with GERD. Both clinical and histopathological findings were synthesized, including prevalence estimates and odds ratios where available. Results: GERD affects approximately 10%–20% of individuals in Western countries and about 5% in Asian populations, with severe disease present in ~6%. Studies have consistently reported mucosal inflammation in patients with GERD. Watanabe et al. observed erythema and ulcerations in 15.2% of GERD patients (95% CI: 9.6–23.3%). Burning mouth symptoms were identified in 11.2% of GERD patients (95% CI: 8.7–14.3%), markedly higher than the ~3% prevalence in the general population. Histopathological and cytological studies further demonstrated nuclear atypia and epithelial thinning in GERD-affected mucosa, raising concerns for dysplastic progression. Conclusion: GERD is associated with a higher prevalence of oral mucosal inflammation, ulcerations, and burning mouth symptoms, with early evidence suggesting potential contributions to epithelial atrophy and dysplasia. While heterogeneity across studies limits definitive conclusions, these findings highlight the importance of oral examination in patients with GERD. Larger, well-controlled studies are warranted to confirm causality and clinical implications.